NO PERMIT NUMBER No. Street
APPLICATION FOR BUILDING PERMIT
CITY OF CUPERTINO
Sanitary No.
File No.
Date 3O 196 70
6-
/ --!'�Application is hereby made for a permit to
A15rzLs a story, Type tqe'r (—
to be occupied only as 4.,�Y/li4• F6E
in accordance with Plot Plan, Plans and Specification filed herewith..
Estimated Value of Improvements S gJ96
FEE$ Plan Check $
n /LQO/ 0
Ower J,66 -I. 4, W/ Address
Contr. Address
Phone
�/ �
Phone 2'Z / 31 7 State License A4 M C�—O Gt).Ajd�e
Approved WILLIAM D. RFntr=tnru
APPLICATION FOR ELECTRICAL PERMIT
�
Date /a )' y 196 d FEE$
Contr. Address
Phone aS ?,3 State License
Approved
APPLICATION FOR PLUMBING & GAS PERMIT
Date 196 GAS FEE $
PLUMBING FEE $
Contr. Address
Phone State License
Approved
APPLICATION FOR APPLIANCE PERMIT
Date 196 FEES
Contr, Address
Phone State..Licanse
Approved
Applicants agree not to violate any of the
Workman's Compensation Laws of the
State of California
RECORD OF INSPECTION APPROVALS
BUILDING
DATE INSPECTOR MISC.
PAD FINAL
FOUNDATION 7- TL3
UNDERFLOOR
FRAME
LATH & PLASTER
GRADING FINAL
FINAL BLDG.
ELECTRICAL
DATE INSPffjfTOR MISC.
UNDERGROUND ROUGH t
ROUGH WIRING-
IW
IRING '
FINISHED WIRING ;13
-
FIXTURES
MOTORS
FINAL >-1
PLUMBING, GAS & APPLIANCE
DATE INSPECTOR MISC.
BACK FLOW REQ. '
SANITARY NO.
UNDERGROUND ROUGH
PARTIAL ROUGH
ROUGH COMPLETE
MAIN DRAIN
FINAL PLBG.
FINAL GAS
FINAL APPLIANCE
DATE INSPECTOR MISC.
MISC
MISC
MISC
" i:•.